TAKES ON THE AIDS INDUSTRY
South African President queries
by Tom Bethell
AIDS 8 (3) 1-4 March, 2000
SOUTH AFRICAN PRESIDENT Thabo Mbeki stunned the AIDS industry
and its critics in February by announcing that he would host an
international panel of experts to examine the science of AIDS, its
treatment, and the role of the pharmaceutical companies. News of
the panel, scheduled to meet in Pretoria May 6 and 7 and to include
supporters and critics of the HIV-causes-AIDS model, elicited the
expected response: HIV-AIDS critics embraced the chance to participate
in an open exchange of scientific ideas, while HIV-AIDS proponents
expressed indignation, not-so-veiled threats, and insults.
Mbeki, the first head of state to rethink the HIV-AIDS issue, has
been suspicious of the received wisdom for some time. Last October,
he requested a safety review of the "anti-HIV" drug AZT,
saying that "a large volume of scientific literature"
claimed that its toxicity made it "a danger to health."
It would be "irresponsible" not to heed such warnings,
In January, Mbeki sent RA Group board member David Rasnick a list
of questions. To assist with the reply, Rasnick enlisted African
History professor Charles Geshekter of California State University,
Chico, who last December met Mbeki's health minister in South Africa,
and has spent extensive time throughout the continent. Their letter
to Mbeki suggested a non-HIV explanation for Africans diagnosed
as having "AIDS": the clinical symptoms of diseases traditionally
caused by poverty, malnutrition, poor sanitation, and parasitic
infections were being blamed on a retrovirus and given a new name,
AIDS. "There are billions of dollars available for AZT and
condoms but hardly a penny for food, school, education, clean water
and jobs," they said.
Two days later, Mbeki phoned Rasnick and asked for his support in
reassessing AIDS and AZT. Rasnick gave it, and also committed the
Group for the Scientific Reappraisal of AIDS (which publishes RA)
and the International Coalition for Medical Justice to the same
goal. Then came the official call for the panel.
According to the South African News Agency (SAPA), Mbeki's actions
"met with a storm of protest from doctors, AIDS activists and
the media, who said the dissident arguments had been discredited
years ago, and that South Africa risked becoming the laughingstock
of the world." Mail & Guardian editor Philip van
Niekerk, a vehement defender of the orthodoxy, asked why South Africans
are being sidetracked "by a group of very fringe people sitting
in California." He added that these California-sitters "are
actually quite reactionary politically, in the sense that they come
originally out of an almost anti-gay kind of position. Why are we
wasting our time with that?"
Johannesburg's Sunday Independent quoted Dr. John Moore of
the Aaron Diamond AIDS Research Center in New York as saying that
he was "flabbergasted." Mbeki had "given lifeblood
to a dead cause," he said. Moore said that the matter would
be brought to the attention of people at "very serious levels
in the US government. [Mbeki] needs to get proper advice, from his
peers." Questioning AIDS was "tantamount to Holocaust
denial because the implications are so serious," he added.
Dr. Seth Berkley of the International AIDS Vaccine Initiative has
also likened the skeptics "to those who believe the Holocaust
did not occur."
Not only was "reappraising AIDS" as untenable as "reappraising
the Holocaust," it was dangerous enough to constitute a holocaust:
"A charge of genocide would not be inappropriate," Moore
warned Newsday's Laurie Garrett.
The head of South Africa's Medical Research Council, Professor Malegapuru
Makgoba, told the Mail & Guardian that the AIDS dissidents
are "failures in their own countries," and "out to
get famous." Warning that South Africa is becoming "fertile
ground for pseudo-science," he described President Mbeki as
"medically and scientifically naive."
Mbeki himself has been taking it calmly. Replying to the chairperson
of the Durban conference, Professor Jerry Coovadia, Mbeki said he
was surprised to find how many people claiming to be scientists
"are determined that scientific discourse and inquiry should
cease, because 'most of the world' is of one mind." He added:
"By resorting to the use of the magic wand at the disposal
of modern propaganda machines, an entire regiment of eminent 'dissident'
scientists is wiped out from the public view, leaving a solitary
Peter Duesberg alone on the battlefield." (Duesberg is engaged
in cancer research at UC Berkeley and has not commented on the recent
furor about African AIDS.)
This summer, over ten thousand AIDS researchers will gather for
the 13th International AIDS Conference in Durban, South Africa (July
9 to 14). The following companies are major sponsors of the conference:
DuPont Pharmaceuticals, Pharmacia & Upjohn, Glaxo Wellcome,
Bristol Myers Squibb, Merck, Hoffman LaRoche, Abbott Laboratories,
and Boehringer Ingelheim.
In resisting the AIDS orthodoxy in Africa, dissidents are joined
by science journalist Michael Fumento, author of The Myth of
Heterosexual AIDS (Regnery, 1993). Fumento believes that HIV
causes AIDS, but does not believe that the African epidemic is real.
He thinks the AIDS-in-Africa propaganda campaign has been driven
by the budget concerns of the existing beneficiaries of AIDS spending.
The failure of American AIDS to "explode" into the general
population led the authorities to look for the phenomenon elsewhere.
New AIDS cases in the US began falling before the introduction of
"protease inhibitor" therapy, and from 1997 to 1998 dropped
from about 60,000 to 48,000. Of teenagers diagnosed in 1998, only
68 were classified as "heterosexual contact." Among women,
AIDS diagnoses fell from 13,000 in 1997 to 11,000 in 1998.
If the very high AIDS spending by the US government is to be sustained,
the emergency would have to be drummed up elsewhere. Prof. Geshekter,
who has made 15 trips to Africa, sees things in much the same way.
"AIDS is dwindling away in the US," he said. "The
numbers are down. What are the AIDS educators to do? Africa beckons."
The director of research of the Statistical Assessment Service in
Washington, D.C., has also shown skepticism. He points out that
in its latest disease rankings WHO dropped TB down the list and
moved AIDS up. The best explanation, David Murray told Michael Fumento
for an article in the journal Philanthropy, is that both
the TB and AIDS figures are guesses, and that WHO simply shifted
a huge chunk of deaths out of the TB category into AIDS. Murray
was unable to get anyone from the World Health Organization to comment
on this highly probable scenario.
Journalists covering Mbeki's "AIDS reappraisal" might
write about the topic more intelligently, accurately, and sensibly
if they considered the following key points:
1. AIDS in Africa may be diagnosed without HIV test
is sufficient to cast doubt on all claims about AIDS on the continent.
AIDS is a new name for 30-odd diseases found in conjunction with
a positive test for antibodies to HIV. Being "HIV-positive,"
then, is the unifying and defining condition of AIDS. But in Africa
the HIV test does not have to be conducted. This means that doctors
and health authorities can attribute disease and death to AIDS with
no fear of contradiction.
The decision to dispense with the HIV test was made in October 1985
by American public health officials at a conference in Bangui, in
the Central African Republic. The organizer, Joseph McCormick of
the Centers for Disease Control, wanted a diagnostic definition
of AIDS for countries lacking the equipment to perform blood tests.
He also convinced representatives from the World Health Organization
in Geneva to set up their own AIDS program. Observing sick people
in Zaire hospitals persuaded the Americans that AIDS now existed
in Africa -- this before HIV tests had even been conducted. They
"found" that slightly more women than men were affected.
Back in America, reporter Laurie Garrett wrote in The Coming
Plague (1994), McCormick told an assistant secretary of Health
and Human Services that "there's a one-to-one sex ratio of
AIDS cases in Zaire." Public health officials now had what
they wanted: heterosexual transmission. Suddenly we were all at
risk. AIDS budgets would soar. Even though she devoted several pages
to the Bangui meeting, Garrett failed to make the key point that
the HIV test had been abandoned.
Deceptive labeling is central to an understanding of AIDS in Africa.
The HIV test-free "Bangui definition" of AIDS, reached
"by consensus," included these major components: "prolonged
fevers (a month or more), weight loss of 10 percent or greater,
and prolonged diarrhea." Now many traditional African diseases,
pandemic in poverty-stricken areas with tropical climates, open
latrines, and contaminated drinking water, had a unifying, simple
new umbrella term: AIDS. And an attractive one, as it qualified
diagnosing physicians and patients for new sources of funds from
The Bangui definition was published in WHO's Weekly Epidemiological
Record (1986: 61: 69-76), and in Science magazine (21
November 1986). But it seems not to have been published in US newspapers,
of which the leader has been the New York Times . The paper's
main AIDS reporter, Lawrence K. Altman, is himself a former public
health officer, and like McCormick worked for the CDC's Epidemic
Intelligence Service. In November 1985 Altman wrote two extensive
stories for the Times on African AIDS, one including a section
on the Bangui meeting. But like Newsday 's Garrett, Altman
omitted the fact that, in Africa, AIDS can be, and usually is, diagnosed
without an HIV test. (Aaltman did not return phone messages requesting
his comments for this article.)
2. The HIV test is not specific to HIV
When they are
used, HIV tests detect antibodies with an assortment of proteins
that are not unique to HIV. Neither the HIV Western Blot nor ELISA
antibody tests respond exclusively to antibodies generated by exposure
to HIV. Other microbes that can trigger these same antibodies include
some that are epidemic in Africa: those responsible for tuberculosis,
malaria, and leprosy. In 1994, an article in the Journal of Infectious
Diseases concluded that HIV tests were useless in central Africa,
where these microbes are so prevalent that they cause a 70 percent
false-positive rate. Tests may be positive if immune systems are
compromised for many reasons, including chronic parasitic infection
and anemia. In South Africa, tests are mostly conducted on pregnant
women, yet pregnancy itself is a condition that may yield a false
positive. The packet insert in the ELISA test kit from Abbott Labs
contains the disclaimer: "There is no recognized standard for
establishing the presence or absence of HIV-1 antibody in human
blood." All the claims that AZT reduces the maternal transmission
of HIV run afoul of this difficulty. The tests are non-specific.
We don't really know whether the mothers are infected in the first
Mark Schoofs, who recently won the Pulitzer Prize for his eight-part
series on African AIDS in the Village Voice, contracted malaria
during his six-month stay in Africa. Had he taken an HIV test, he
might easily have tested positive. Even without the test, he probably
qualified as an "AIDS" patient by the Bangui definition.
Despite the unlimited page-space at his disposal, Schoofs, too,
failed to explain that the official definition allows almost anything,
including his own illness, to be called AIDS in Africa.
3. AZT is more toxic, less effective than initially thought
AZT was designed
in 1964 as cancer chemotherapy but never approved for that use because
it was considered too toxic. The "double-blind, placebo-controlled"
trials of the drug in 1986 that led to FDA approval were paid for
by the drug's manufacturer, Burroughs Wellcome (today, Glaxo Wellcome).
Approval came only after several thousand AIDS activists demonstrated
in the grounds and corridors of the FDA building in Rockville, Maryland.
The safety and efficacy trials became unblinded and were prematurely
terminated. Patients figured out who was receiving drug and who
placebo, and they swapped doses in mid-trial. Trials were ended
after only four months, before the adverse effects appeared. A later
European investigation called the "Concorde study" showed
that AZT conferred no benefit. Since the drug was first approved,
its toxicity has caused so much concern that its recommended dosage
level has been sharply reduced.
No one alleges
that HIV spreads in Africa by homosexual contact or by intravenous
drug use. This leaves heterosexual transmission. But Nancy Padian
and associates showed in the August 15, 1997 issue of the American
Journal of Epidemiology that male-to-female transmission of HIV
is extremely difficult, requiring on average one thousand unprotected
sexual contacts. Female-to-male requires on average eight times as
Many more unflattering details about AZT can be gleaned from these
"approved" sources: "Imminent Marketing of AZT Raises
Problems," by Gina Kolata, Science, March 20, 1987;
"Doctors Stretch Rules on AIDS Drug: Some Give Possibly Toxic
AZT Before Symptoms Develop," by Gina Kolata, New York Times,
Dec 21, 1987. "The Return of AZT," by Terence Monmaney,
Discover, January 1990. "AZT and AIDS: The Doubts Persist,"
by Phyllida Brown, New Scientist, 26 October 1991. "After
5 Years of Use, Doubt Still Clouds Leading AIDS Drug," by Gina
Kolata, New York Times, June 2, 1992. "Toxic Hope,"
by Linda Marsa, Los Angeles Times Magazine, June 20, 1993.
"New Study Questions Use of AZT in Early Treatment of AIDS
Virus," by Lawrence K. Altman, New York Times, April
2, 1993. "The Doctor's World: AIDS Study Casts Doubt on Hastened
Drug Approval in US" by Lawrence K. Altman, New York Times,
April 6, 1993. "Benefits of Often-Used AIDS Drug Are Questioned,"
Associated Press, New York Times, March 17, 1994. "Children's
AIDS Study Finds AZT Ineffective," by Lawrence K. Altman, New
York Times, February 14, 1995.
4. HIV-AIDS model slanders African sexual mores
The claim of a vast heterosexual epidemic in Africa therefore obliges
Western health experts and "educators" to impute gross promiscuity
to Africans en masse. This amounts to attributing Hollywood-style
morals on African villagers. Absurd and undocumented tales of African
truck drivers have been invented and duly accepted. Gullible reporters
such as ABC's David Marash and Ted Koppel, on a special three-night
edition of "Nightline" March 8-10, 2000 ("AIDS in Africa:
The Disappearing Society") have shown themselves true believers
in this cause. Even good liberals like Nobel Prize winner Nadine Gordimer,
have been willing to impugn African morals. (Though in her April 11,
2000 New York Times essay, "Africa's Plague, and Everyone's,"
she sugar-coated it. African promiscuity, she wrote, "is difficult
to condemn when sex is the cheapest or only available satisfaction
for people society leaves to live on the street.")
But the rest of us are entitled to a little skepticism. It is understandable
and justifiable that African leaders should question and even reject
these ethnic fictions and racial slanders.
5. The political economy of AIDS
developed into a vast international aid program in which the recipients
are identifiable and the donors (taxpayers) are anonymous. Benefits
are focused, costs are diffused. Governments, pharmaceutical companies,
AIDS activists and educators, retrovirologists, scientific publications,
and people with AIDS work together symbiotically, budgets are fattened,
and taxpayers worldwide (but mainly in the US) pay up willy-nilly.
US Federal spending on AIDS increases at about 10 percent a year,
even as case loads fall, topping $10 billion in the last budget
cycle. Much of the money is sent to the National Institutes of Health,
and to health-care and housing programs. The states add on billions
of their own. All this pays for the lion's share of the drugs, and
relieves the pharmaceutical companies of worrying about whether
their customers can afford their products. For AIDS patients, health-care
The NIH-funded investigators will fiercely uphold the consensus
in favor of the received science. Now and then, the Centers for
Disease Control and Prevention will report discernible "progress,"
but always with the caution that the problem has not gone away.
Then, every year or so, "sobering realities" will be reported.
The virus will have "mutated," weakening the drugs. A
vaccine trial didn't pan out. In a far away country (currently,
South Africa and Zimbabwe are in fashion), HIV infection rates of
25 or 30 percent are suddenly "discovered." Or fully two-thirds
of the South African army will be "infected!" Now, once
more, we have a full-blown crisis. Showing no concern that they
are being used, good soldiers Laurie Garrett (Newsday ) and
Lawrence Altman (NYT ) will play their appointed role, without
a trace of skepticism, and be rewarded with front-page headlines.
"Plagues" are more urgent and scary than dysentery or
malaria, after all. Science magazine's coverage will be
scarcely any different.
The message conveyed never changes: More funding is urgently needed!
The drug companies fear the activist organizations and their shakedowns.
For protection, therefore, their contributions are generous. Project
Inform gets to pay its bills. The remunerated activists call off
the demos and redirect their members to get in touch with their
congressmen: more money must be spent on AIDS! Perennial NIH lab-funder
Anthony Fauci wisely befriends gay activist Larry Kramer. It's a
cozy relationship, beneath the contrived contretemps. PWA's get
their health care paid for, go-along scientists get their labs fully
funded, public health officials get big annual budget increases
and the resources to hire more assistants. As for the drug companies,
they have been making so much money that they can afford to underwrite
these huge biennial AIDS jamborees -- such as the one upcoming at
Durban -- which invariably help fan the flames for more of the funding
that inevitably finds its way back into their laps.
Peter Piot, the head of UNAIDS, saw what was going on. In a revealing
comment in the June 19, 1998 Science he wrote: "Unlike
any health problem before, there has been a uniquely close involvement
of and pressure from individuals and groups infected with or affected
by HIV." These were "mainly gay men in the industrialized
world." He might well have added that retrovirologists were
also among the "affected." Anyway, the infected and the
affected were "setting the agenda for AIDS research,"
Piot wrote, "pressing for the immediate application of results,"
"lobbying for increased funds," "setting the research
agenda in clinical trial committees, boards of foundations, advisory
boards of pharmaceutical companies, and scientific conferences."
It would be hard to improve on that.
AIDS "provides a new paradigm for the interaction between science
and society," he saw, and "between public health departments
and affected communities." More plainly, science had at last
been subordinated to politics. And public health departments had
found themselves an influential, placard-bearing, media-savvy constituency--a
potent lobby for funding increases. Piot was probably correct in
saying that this was something new. Cancer researchers and patients
have since begun to form the same symbiotic coupling.
6. Politics, not science, guides AIDS policies
involves a realization that political rather than scientific considerations
drive corporate and government AIDS policies. When activists confronted
Pfizer's chief executive in March, the company swiftly agreed to
give away its "AIDS" drug Diflucan in South Africa. The
activists did not appreciate the implications of prescribing this
antifungal medication to treat patients supposedly ill from a retroviral
"The drug makers are coming under increasing pressure to provide
help to the developing nations," Michael Waldholz wrote in
the Wall Street Journal, "especially because the AIDS
conference this year will be held in Durban, South Africa, where
world-wide media attention will focus on the lack of access to the
drugs in the developing world."
Several months earlier, the Bristol-Myers Squibb Foundation shelled
out $100 million to five African countries. One must imagine that
Squibb would prefer the recipient countries to apply that money
to HIV-based AIDS programs, which would involve purchasing and administering
anti-HIV drugs, but not to anti-poverty programs, which would alleviate
the health-destroying factors of African poverty.
Late last summer, AIDS activists began disrupting Vice President
Al Gore's early campaign appearances. Gore met privately with Mbeki
to discuss ways the US could help South Africa obtain cheaper AZT.
But in October, Mbeki in a speech to provincial leaders questioned
the drug's safety. A few weeks later, in Seattle, President Clinton
promised that the US would help countries like South Africa obtain
HIV-based AIDS drugs. In January, Gore pledged support for a Congressional
bill to supply the UN $350 million for HIV-based AIDS programs.
None of this money is intended to assist targeted countries in evaluating
for themselves the cause or causes of illness in their residents
who receive "AIDS" diagnoses.
This sits poorly with Mbeki, who has found no convincing scientific
justification for devoting South Africa's anti-AIDS resources exclusively
to HIV-based programs. Those resources, some scientists think, belong
in anti-poverty programs, not the anti-HIV and safe sex programs
intended by Clinton, Gore, and UN officials. Mbeki wants to hear
first hand what those dissenting scientists have to say, and in
a dialog that involves scientists who advocate the HIV model.
Will Mbeki manage to withstand the the hysteria, name calling, and
vilification that has exclusively composed the response so far from
the HIV scientists, who are pressuring him to cancel the May 6 panel?
If Mbeki resists their relentless campaign and stages his proposed
panel, he would have taken another unprecedented step in constructing
the first national AIDS policy based on a thoughtful and open examination
of the facts.
Bethell writes for the American Spectator and
the National Review.